| NPI | 1376987388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN DONALD FRIED Dentist/Partner 718-283-7428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 024825) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 035509) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 037837) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 049090) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 044016) | |
| Enumeration Date | 2013-04-21 |
| Last Update Date | 2017-04-18 |